Fundamental cytokine regulating remodelation of the skeleton is receptor activator of nuclear factor
kappa B ligand (RANKL). RANKL is counter regulated by soluble receptor osteoprotegerin (OPG).
While RANKL activates osteoclastic bone resorption, the OPG stimulates bone formation.
RANKL/OPG system (TRANCE axis) is activated in favour of RANKL in estrogen deficiency,
inflammation, bone malignancies and during the treatment with glucocorticoids. TRANCE axis is
functional also in other tissues including vessel wall, where dysbalance with superiority of RANKL
leads to atherogenesis. Molecules blocking RANKL (specific antibodies and OPG) are potential drugs
for treatment of osteoporosis, atherosclerosis, inflammation diseases, myeloma or osteolytic bone
metastases. This review is focused on pathogenetic role of TRANCE axis in the development of
osteoporosis and atherosclerosis and on its use in diagnosis and treatment of both degenerative diseases.
RANKL, osteoprotegerin, osteoporosis, atherosclerosis.